Majority of hospitals stumbled on public health reporting before the strain of a global pandemic

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Small, rural, independent and critical access hospitals frequently reported issues electronically exchanging information with public health agencies back in 2019, according to new data from the Office of the National Coordinator for Health Information Technology. (ipopba/Getty Images)

Even before the onset of the COVID-19 pandemic, U.S. hospitals had a hard time reporting public health information to authorities.

Seventy-one percent of hospital leaders surveyed in early 2020 said they experienced at least one challenge when attempting to electronically report to public health agencies during 2019, according to a recent data brief from the Office of the National Coordinator for Health Information Technology (ONC).

What's more, about 19% of hospitals indicated that they experienced three or more challenges throughout the year.

Half of hospital leaders said they lacked the capacity to electronically exchange information with public health agencies throughout both 2018 and 2019, the ONC wrote.

Interface-related issues, such as cost and complexity, were the next most prevalent roadblocks, and significantly increased from 37% of responders in 2018 to 40% in 2019. Differing vocabulary standards also saw a significant year-to-year raise from 16% to 19% while difficulty extracting relevant information from the EHR was similar at 16% and 17%.

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“These findings are consistent with 2017 and 2018 survey findings, suggesting these were not emergent issues,” the ONC wrote in the data brief.

ONC collected its data from the 2019 American Hospital Association Annual Survey’s IT supplement, which was fielded from January 2020 to June 2020 and included responses from 2,606 hospitals.

Public health reporting challenges were more frequently reported among small, rural, independent and critical access hospitals, the ONC wrote, particularly in regard to interface issues, EHR data extraction and awareness of where to send information in order to meet reporting requirements.

The ONC also noted that these rates varied “substantially” across different states and that challenges were less frequently reported among facilities that were participating in a state, regional or local health information exchange (HIE).

“While it is possible that hospitals experiencing issues with data extraction and reporting were less likely to connect to HIEs, our findings suggest that HIE participation may be helpful in mitigating certain public health reporting challenges,” the office wrote. “Studies have shown that HIEs can support hospitals and public health agencies by addressing gaps in missing information, supporting public health reporting and monitoring, and providing other data services to help enable exchange.”

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The ONC has been doling out funds over the past year to help providers beef up their public health reporting.

In January, the office announced $20 million in Coronavirus Aid, Relief and Economic Security (CARES) Act funding toward stronger data sharing between HIEs and immunization information systems. In June, it went on to announce $80 million in American Rescue Plan funding to establish a public health informatics and technology workforce development program.

The ONC’s data brief also highlighted two technical certification criteria included in the ONC Cures Act Final Rule, Electronic Health Information Export and Standardized API for Patient and Population Services. Although these criteria are primarily designed to increase interoperability and patient access to health information, the office affirmed that the improvements to electronic health information exchanging between health IT systems will be a boon to public health reporting.